Lower butt sagging 1 year after posterior body lift. Would a butt lift or butt implants help? (photos)

Question

I had a posterior body lift in February 2022 with auto flap augmentation. I also had fat injected in my buttocks from liposuction of my saddlebags and flanks. It looked great for about nine months and now it is sagging and flat on the bottom. I didn't have a lot of fat to inject so I'm not sure if that is the problem. Would an inferior butt lift help? Or would butt implants be the answer? Please don't tell me there is nothing that can be done - I am willing to do anything!

J. Timothy Katzen, MD, FACS · Answer

Hi dburgwa,

Thank you for your question regarding lower butt sagging one year after a posterior body lift and whether a butt lift or butt implants would help. Thank you for providing your history and pictures. After analyzing your pictures, it's evident that you have buttock skin sag, particularly in the lower third of your buttock. You also have a noticeable loss of volume in your entire buttock. I do not believe an inferior buttock lift would be beneficial, as it would likely further flatten your buttocks. What you need is more buttock volume. Additionally, I don’t think fat transfer is a viable option since you don’t appear to have a substantial amount of fat elsewhere. If you were to consider a Brazilian Butt Lift (BBL) involving fat transfer, you would need to gain about 20 pounds to allow for sufficient fat harvesting.

Most plastic surgeons would agree that buttock implants are your best solution. Buttock implants, which are approved by the USFDA, are made of a semi-solid silicone. Technically, these implants cannot “break,” preventing any risk of silicone leakage throughout your body. Often, buttock implants can be inserted through your existing posterior body lift incision. They will not only provide volume but will also lift your buttock skin. There are three typical positions for placing the buttock implant: on top of the muscle, within the muscle, or under the muscle. Most plastic surgeons prefer to place the implant within the muscle. In any case, buttock implants are generally considered to provide the most effective results in situations like yours.

I hope I have addressed your question regarding lower butt sagging one year after a posterior body lift and whether a butt lift or buttock implants would be beneficial. Good luck.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Ryan A. Stanton, MD · Answer

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

Buttock “sagging” is usually a combination of loss of volume or deflation (after weight loss, liposuction, or post-BBL) and/or the effect of aging and gravity. So,  I personally first treat patients like you by restoring volume to the buttock with a buttock implant. This will create a more desirable smooth and rounded perky buttock profile. If not adding volume with an implant, the buttock will be shortened but may appear more flat with just a buttock lift. A lower buttock tuck is usually then performed at six months following implants. In this sequence, the implants have fully settled into final position so that any remaining loose skin can be most accurately identified and removed with the lower buttock tuck. Please note, because an extremely few number of board certified plastic surgeons specialize in buttock implants, you may have to travel away from your local area to seek consultation with this particular type of surgeon.  Glad to help.

Randal Haworth, MD, FACS · Answer

Based on your pictures, a combination of collagen induction therapy (CIT) also called Macroneedling and a bbl could be the answer to the issue you’re describing.

Of course, an « in person » exam is necessary.

I hope this helps,
best of luck !

Felix Omar Márquez, MD · Answer

Hi, thanks for your question and photos. By the pics, you are a candidate for butt implants. You can have great results, naturally and according to your complexion. Consult a board-certified plastic surgeon in your area for a physical exam. Good luck!

Mats Hagstrom, MD (license on probation) · Answer

Restoring volume may be challenging regarding fat transfer, especially on individuals with a history of significant weight loss.
Most plastic surgeons in the United States don’t offer a gluteal implants. This fairly good reason for this trend. The procedure has historically been viewed as having a high complications and high patient satisfaction long-term.
Implants can be a successful strategy, but should only be done by providers who have excessive experience and patients need to realize what is involved with the procedure, including the acceptance of potential complications and failure.
An inferior gluteal lift will leave scars and is a trade-off that may be worthwhile for some individuals.
Harvesting sufficient amounts of fat for a successful fat, transfer is a trade-off between having excessive amounts of areas treated with Liposuction as a cost benefit ratio, which may be worthwhile for some individuals.
Provider selection is probably the most important variable, regardless of what procedure you choose.
Best,
Mats Hagstrom, MD

Lower butt sagging 1 year after posterior body lift. Would a butt lift or butt implants help? (photos)

Answers (5)

Answer: Butt implants

Answer: Butt implants

Answer: Treatment options

Answer: Treatment options

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Lower butt sagging 1 year after posterior body lift. Would a butt lift or butt implants help? (photos)

Answers (5)

Answer: Butt implants

Answer: Butt implants

Answer: Treatment options

Answer: Treatment options

Browse related questions

Recommended reading

Everything you need to know about Butt Lift

Our mission is to create a world where every investment in modern beauty is Worth It.